One of the biggest questions of mTBI is how long do post-concussion symptoms last. We are programed to forget past symptoms, but those that remain feel unending. A key to staying hopeful while managing PCS symptoms is tracking progress in concussion recovery. I like to use the following technique I call “Knowing your Now” when working with post concussion syndrome patients. This is a simple strategy for tracking progress in concussion recovery that will help you stay motivated.
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Mental Health and Concussion
The initial symptoms of a concussion can be so overwhelming that they can challenge our sense of self. The continuity of life is broken. When that huge initial change is followed by extremely slow recovery, it is easy to develop anxiety or depression with post-concussion syndrome. Anxiety and depression themselves can negatively impact the brain and prolong recovery. Many PCS patients turn to drug or alcohol post concussion which further exacerbates symptoms. While anxiety and depression both have neurochemical causes associated with brain trauma, any method you use to keep a healing mindset and hope for a full concussion recovery will help you continue your healing journey.
Knowing your Now
This technique is beneficial because it helps the patient with long term post concussion syndrome recognize that they are making progress. If possible, go back in time to the weeks after your original injury and write down all the concussion symptoms as well as all the physical injuries or symptoms you had at the time. It may be difficult to remember, but as you will see, that is a major point of the exercise. You can also write down specific challenges you have as a result of your symptoms. These may include social and work challenges or even personality changes from head injury. On the positive side, write down your strengths; the characteristics that keep you going and contribute to progress in your healing from concussion.
If you can’t remember all your symptoms right away, that’s ok. What is more important is being mindful of your current concussion symptoms and challenges. Write these on a separate piece of paper or in a new file. Make sure to date the list. If you were able to remember your initial symptoms, do a quick comparison. This is how far you have already come. Hopefully, you have made some progress, however small. You have not given up, so you will make more progress.
Some symptoms are easy to understand and explain: You may notice that it’s harder to read when you are tired, or perhaps you get confused when you’re in a group and several people are talking at the same time. Certain types of pain and challenges coincide with certain activities. Other issues may be harder to understand. You may suddenly get angry or sad for no apparent reason. Perhaps you have trouble expressing yourself on certain types of topics. Symptoms may get better or worse randomly.
Whether or not you understand the symptoms and challenges you’re having, it’s good to get them down on paper. It makes them somehow more concrete and manageable. It’s also very handy for when you go to see a health care practitioner. You can just hand them a piece of paper rather than trying to remember everything.
Acknowledging your own strengths may be even more important. You need to give yourself credit, celebrate your victories and be thankful. Sometimes it feels like nothing is changing, but if you write these things down, you may see that they are.
Assessing Concussion Recovery Progress
In a month or three months, check the document, change the date, and update as needed. Do a “save as” so the previous document is preserved. If it’s handwritten, jot down a new list. Repeat this process again in 3 months.
It’s very difficult to be aware of ourselves when head injured. It’s hard not to become impatient with your progress or not recognize the progress you’ve made. Taking time to update your symptoms, strengths, and challenges monthly or every three months keeps you in the present while allowing you to be mindful of progress. This can provide a sense of control and continuity to what otherwise feels like chaos.
Personally, when doing this exercise in my own healing, I often would be reminded of symptoms I’d forgotten I had. This is a very good feeling. It can take you out of that feeling of never ending suffering and shift your mood from doom and gloom to one of hope for concussion healing. Remember earlier when I wrote that not being able to remember past symptoms was a major point of this exercise? This is why. To move forward, we must recognize our victories. This is the source of hope for concussion recovery.
Neuropsychology and concussion
While the above exercise is not meant as a replacement for neuropsychological evaluation after concussion, there are certain areas of overlap. Both are a kind of inventory of symptoms. Both provide baselines from which to make future comparisons. The value of neuropsychology is that it can identify not just symptoms, but specific areas of the brain affected by concussion. It may bring out patterns that indicate imbalances in certain neurotransmitters. This kind of information can be used by neurologists, functional medicine practitioners, neuro-rehab specialist or psychologist to provide more individualized concussion treatment.
In terms of helping to recognize change though, it can have the same benefit of supporting hope and motivation by tracking progress in concussion recovery. Neuropsychological report can provide a more objective, quantified read on how you’re progressing. You can find a neuropsychologist through your general practitioner or a neurologist. You may also find neuropsychologists on www.concussionprofessionals.com. This is an organization I recently created for the purpose of connecting concussion patients to tele-health and local concussion specialists.
The downside of using neuropsychological evaluation of concussion symptoms to track progress is that it can be expensive. Insurance may cover it the first time for you, but you may need to pay out of pocket for follow-up evaluations. This is not to say that it is not worth it, just that it may present a financial challenge.
Why tracking progress in concussion recovery yourself is important
Though your “Know your Now” sheet will not be nearly as comprehensive as a neuropsychological evaluation for post-concussion syndrome, in certain aspects, it can have greater value.
Much of what we look for in taking care of our health involves finding other people to do things for us. It’s important that we do that. Chances are that you are not concussion treatment specialists, though you may feel like you are becoming one. Looking for help is active, but receiving help is passive.
Part of dealing with post-concussion syndrome is the frustration of not being able to do sometimes even simple things. The sense of competence is challenged and this can impact hope. You are the most qualified person for tracking progress in concussion recovery for yourself. Who knows your symptoms, challenges and strengths better?
When you update your “Know your Now” sheet, you are the one who can take credit for any progress you have made. Even if that progress was made through guidance or therapies you received from others, it was you who decided to consult those concussion experts, you followed through and you benefitted. Knowing that you are responsible for your own progress lets you take ownership of your victories and will give you motivation and hope for ongoing concussion recovery.
